Alarm Management in

The NICU

Sarasota Memorial Hospital

Located in Sarasota Florida 806 acute care beds; regional

medical center founded in 1925 The second largest public hospital

in Florida, governed by a 9-member Board.

Fully accredited by the Joint Commission, Received 3rd. Magnet Designation in 2014,

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SMH NICU 2012

Level III20 Bed unit

2 large open room layout

Select a new Cardio-Respiratory

Monitor

“GE”

Integrate our current

communication device

“VOALTE”

Select the appropriate Middleware

“Connexall”

How We Started

Voalte Communication System

Apple I-PhoneAble to receive TextPhone Calls both incoming and

outgoingAlarm Management (Displayed)Code Alerts receivedStaff EmergencyDelivery Team is needed

SMH NICU 2014

SMH NICU 2014Level III

33 Private Patient rooms 3 bed transition nursery

Connecting Technology to the Bedside Caregiver and To the Patient

• Alarm’s Nursing Staff Receive

Brady/High Heart Rate

High/Lo Pulse Ox Apnea Leads Off Delivery Team Staff Emergency Code Blue

Escalation SequenceGE Monitor alarms

After 15 seconds and infant does not “self-resolve”

Primary RN receives alarm on Voalte

If no action taken in 15 secondsAlarm escalates to Primary RN’s Buddy & RT (If infant on resp. Support) on Voalte

If no action taken within 15 more secondsPrimary RN and Charge Nurse receive

alarm on Voalte

September 2013

January 2014• Alarm’s Nursing

Staff Receive

Brady Lo Pulse Ox Apnea Leads Off Delivery Team Staff Emergency Code Blue

Alarm Report

September 2013• # of beds equipped with

alarm mgmt. - 10• # of Days- 19 • Total Activations- 23,810• Total time- 172:40:20• Primary Nurse- 13,776• Escalate to Secondary

(Buddy) - 850• Escalate to Primary &

Charge- 9184

January 2014• # of beds equipped with

alarm mgmt. - 31• # of Days- 31 • Total Activations- 38,981• Total time- 286:56:05• Primary Nurse- 38,035• Escalate to Secondary

(Buddy) - 527• Escalate to Primary &

Charge- 419

Concerns/Issues/Solutions

Too Many Alarms -Alarm FatigueNew Leads TrialedGE Monitor Software RecallStaff Provided FeedbackStaff Leary Of Trusting Technology Collaborated With Similar Health Care

OrganizationConnectivity IssuesAppropriate Alarm Notification (Sound)

Opportunities for Improvement

Software UpdateDecrease Alarms and Alarm FatigueReevaluate our Current Alarm

ParametersEnsure Patient Safety

Thank you